Fatigue and physical activity in post-CABG patients: the parallel mediation model of kinesiophobia and self-efficacy : a prospective multicentre and cross-sectional study in China.

OBJECTIVES: The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the age of 45. DESIGN: A prospective multicentre and cross-sectional study. SETTING: The study was conducted in four public tertiary hospitals in China. PARTICIPANTS: A total of 1278 patients who underwent CABG surgery were selected from the case pool, with their surgeries occurring between 3 and 19 months prior to selection. Out of 1038 patients who met the inclusion criteria and were invited to participate in the study, 759 patients agreed to participate and complete the questionnaire. Ultimately, 376 questionnaires were deemed eligible and included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The questionnaire included the following scales: the Chinese version of the Multidimensional Fatigue Inventory (MFI-20), the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI) and the International Physical Activity Questionnaire-Long (IPAQ-L). A serial mediation model was used to test whether the association between fatigue and PA was mediated by kinesiophobia and self-efficacy, in the overall sample and subsamples defined by age. RESULTS: The results confirmed that fatigue was directly (95% CI (-5.73 to -3.02)) associated with PA. Higher kinesiophobia (95% CI (-0.16 to -0.05)) or lower PA self-efficacy (95% CI (-0.11 to -0.02)) were parallel pathways through which higher fatigue impediment reduced PA levels. In both subgroups, the street pathways of kinesiophobia and self-efficacy were altered. In the age, 45-60 years group, kinesiophobia (Boot 95% CI (-0.19 to-0.05)) was a mediator of fatigue on PA levels, while in the 61-75 years age group, self-efficacy (Boot 95% CI (-0.17 to -0.04)) was a mediator of fatigue on PA levels. CONCLUSIONS: A clear relationship between fatigue and PA was mediated by both kinesiophobia and self-efficacy. Furthermore, our findings highlight the importance of adapting the intervention according to the age of the patients, mainly by reducing patients' kinesiophobia in patients aged 45-60 years and increasing patients' self-efficacy in patients aged 61-75 years. It may be possible to improve PA levels in post-CABG patients over 45 years of age by eliminating kinesiophobia and increasing self-efficacy.

Linguistic Validation and Reliability of the Croatian Version of the TOPICOP Questionnaire.

Background and Objectives: This study demonstrates the factor structure and reliability of the Croatian version of the TOPICOP (Topical Corticosteroid Phobia) questionnaire, thereby contributing to further validation and standardization of the measurement of topical corticophobia with dermatological patients or their parents, which directly affects patient or parent compliance, as well as the final therapeutic effect. Materials and Methods: The cross-sectional, observational study was conducted at the University Hospital Centre Split, Department of Dermatovenerology. The research involved inviting 120 participants (age 12-68) who attended the University Hospital Centre Split's Atopy School, patients examined in the Dermatology Outpatient Clinic of the University Hospital Centre Split and diagnosed with atopic dermatitis (AD) or allergic contact dermatitis (ACD), and parents or legal representatives of patients younger than 12 years old. The TOPICOP questionnaire consists of 12 items assessing the three different components of topical corticophobia (worries, beliefs, and behaviour). Respondents evaluated their perception of the correctness of each statement within 10 min of filling out the questionnaire on a four-point Likert scale. Results: The response rate was 94%, resulting in a sample of 113 respondents (109 adults and 4 children). Factor analysis yielded one common factor of relatively high reliability (Cronbach α = 0.85, 95% CI 0.81 to 0.89). No differences were found in questionnaire scores between male and female participants, nor between the parents/legal representatives of dermatological patients and other patients. Conclusions: This research contributes to further development of the appropriate measuring instrument, its practical application, and thus, the better recognition, resolution, and prevention of topical corticophobia as part of the better overall healthcare and treatment of chronic dermatological patients.

Review of psychological effects of dog bites in children.

BACKGROUND: Dog bites are a concerning health problem in children and one of the leading causes of non-fatal injuries in this population. Dog attacks not only cause physical injuries but can also lead to long-term psychological problems. A review was performed to investigate the scope of literature on the psychological effects of dog bites on a paediatric population. METHODS: A literature search was performed on Web of Knowledge database between 1982 to June 2023, returning 249 results. 14 primary studies reporting the psychological consequences of dog bites in children or adolescents were classed as eligible and 9 further studies were added from prior knowledge and bibliographical searches. 23 studies involving 1894 participants met the criteria and were included in this review. RESULTS: Of these 23 studies, 8 were case studies or small case series reports (up to n=4), 14 larger descriptive studies and 1 analytical cross-sectional study. There was a mixture of retrospective and prospective data-gathering. The most common psychological consequences of dog bites in children were post-traumatic stress disorder, dog phobia, nightmares and symptoms of anxiety and avoidance behaviours. CONCLUSIONS: Studies on dog bites in a paediatric population with a specific focus on the psychological consequences associated with dog bites and their management are sparse. Future research and practice should more greatly consider the psychological impact on child victims of dog bites and their family members, as well as their management to avoid the development of mental health issues and improve their quality of life. Future research also needs to ascertain the efficacy of using virtual reality in treating children with dog phobia.

[Feverphobia: Frecuency and related factors associated] / Fiebrefobia: Frecuencia y factores asociados

Introduction: Fever is common in childhood and there is a high level of concern on behalf of caregivers to manage it, this is called "feverphobia". Objective: The objective was to evaluate the presence of feverphobia and associated factors in the study population. Methods: observational, cross-sectional, prospective, and analytical study during 2021 to 2022 through an ad hoc survey self-administered to parents and/or caregivers of patients under 6 years of age who consulted the emergency room of the Dr. Roberto del Río Children's Hospital in Santiago, Chile. The association between sociodemographic variables, knowledge, attitudes, and fears regarding febrile children was analyzed by Chi square and Fisher's test in addition to univariate logistic regression analysis. Results: A total of 381 surveys were carried out. 98% presented some degree of feverphobia. A fever below 38°C was defined by 40.6%. Physical measures were used by 56% of caregivers. The main sequelae feared were convulsions in 82% and 42.7% reported that it could be lethal. A total of 92.1% used unreliable sources of information and 66% had never received education from health personnel on this subject. Logistic regression showed that being a parent, basic or high school level and a thermal threshold below 38°C were the most associated variables. Conclusions: Feverphobia is a current phenomenon in our population and health education to the parents and caregivers could prevent it.

Introducción: La fiebre es común en la niñez y existe un alto nivel de preocupación por parte de los cuidadores para manejarla, a esto se le denomina "fiebrefobia". Objetivo: El objetivo fue evaluar la presencia de fiebrefobia y factores asociados en la población de estudio. Materiales y método: estudio observacional, transversal, con recolección prospectiva y analítico durante el 2021 a 2022, a través de una encuesta ad hoc auto administrada a los padres y/o cuidadores de pacientes menores de 6 años que consultaron a la emergencia del Hospital de Niños Dr. Roberto del Río en Santiago de Chile. Se analizó la asociación entre las variables sociodemográficas, conocimientos, actitudes y temores frente al niño febril mediante Chi cuadrado, Fisher además de análisis de regresión logística univariante. Resultados: Se realizaron 381 encuestas. El 98% presentó algún grado de fiebrefobia. El 40,6% definió fiebre bajo los 38°C. El 56 % de los cuidadores utilizaba medidas físicas. La principal secuela temida por los tutores fueron las convulsiones (82 %) y un 42,7% refirió que podía ser letal. La mayoría (92%) utilizó fuentes de información no confiables y dos tercios (66%) nunca recibieron información sobre el tema por parte del personal de salud.  La regresión logística evidenció que el hecho de ser progenitor, el nivel de escolaridad básica o media y un umbral térmico menor a 38°C fueron las variables mayormente asociadas a la fiebrefobia. Conclusiones: La fiebrefobia es un fenómeno vigente en nuestra población y la entrega de información adecuada y oportuna pudiese prevenirlo.

Development and initial validation of an open-access online Behavioral Avoidance Test (BAT) for spider fear.

The behavioral avoidance test (BAT) is a well-known diagnostic tool assessing fear by directly measuring avoidance behavior. For instance, in spider phobia, participants or patients gradually approach a live spider until they feel too uncomfortable to continue. However, the use of different BAT protocols in various studies hampers the comparability of results. Moreover, conducting the test requires considerable preparation by researchers and clinicians. Thus, we have developed an open-access online BAT (vBATon). We validated its efficacy in measuring avoidance behavior and eliciting feelings of anxiety and disgust by comparing it to a real-life BAT (rl-BAT). Spider-fearful (N = 31) and nonfearful (N = 31) individuals completed a rl-BAT and vBATon on two separate dates within a 1-week interval. As expected, both tests successfully distinguished between spider-fearful and nonfearful individuals. Crucially, equivalence tests confirmed that vBATon captures avoidance behavior, anxiety, and disgust equal to the rl-BAT. Assessing validity, we found moderate to high correlations between vBATon and (a) the rl-BAT and (b) self-report measurements of spider fear (Spider Phobia Questionnaire, Fear of Spiders Questionnaire). Overall, our study displayed initial evidence of validity of vBATon and suggests that it is a standardized, efficient, and user-friendly alternative to rl-BATs for measuring spider fear. It can be utilized in both research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pain and daily interference among reproductive-age women with myofascial pelvic pain: Serial mediation roles of kinesiophobia, self-efficacy and pain catastrophizing.

BACKGROUND: Myofascial pelvic pain (MFPP), which is identified by tender points in the pelvic floor musculature, is a prevalent source of chronic pelvic pain in women. It may lead to physical and mental exhaustion, reproductive concerns, and coping difficulties in daily life and work than the disease itself. Pain-related cognitive processes can affect pain relief and quality of life. Kinesiophobia, self-efficacy and pain catastrophizing are frequently treated as mediators between pain and its related consequences. Greater kinesiophobia and pain catastrophizing have been shown to be associated with adverse functional outcomes, while higher self-efficacy has been related with improved quality of life. Regarding MFPP in females of childbearing age, it remains unclear whether the effects of kinesiophobia, self-efficacy and pain catastrophizing on daily interference are direct or indirect; the influence on each variable is, therefore, not entirely evident. AIM: The present study aimed to evaluate the relationship between pain and daily interference in reproductive-age women with MFPP through kinesiophobia, self-efficacy and pain catastrophizing, as well as to identify areas for future investigation and intervention based on the data collected from this population. METHODS: This is a multi-center cross-sectional study. The study was conducted from November 15, 2022 to November 10, 2023, 202 reproductive-age women with MFPP were recruited from 14 hospitals in ten provinces of China. The demographic variables, Brief Pain Inventory, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, and Pain Catastrophizing Scale were used to measure the participants' related information. The data was described and analyzed using Descriptive analyses, Pearson correlation analysis, and Serial mediation modeling. RESULTS: Pain not only had a direct positive impact (B = 0.575; SE = 0.081; 95%CI: LL = 0.415, UL = 0.735) on daily interference, but also had an indirect impact on daily interference through the independent mediating role of pain catastrophizing (B = 0.088; SE = 0.028; 95%CI: LL = 0.038, UL = 0.148), the chain mediating of kinesiophobia and catastrophizing (B = 0.057; SE = 0.019; 95%CI: LL = 0.024, UL = 0.098), and the four-stage serial mediating of kinesiophobia, self-efficacy and catastrophizing (B = 0.013; SE = 0.006; 95%CI: LL = 0.003, UL = 0.027). The proposed serial mediation model showed a good fit with the collected data. CONCLUSION: The findings illustrate the significance of addressing pain catastrophizing and kinesiophobia (especially catastrophizing), and increasing self-efficacy in pain therapy, and suggest that functional recovery be integrated into pain therapy for reproductive-age women suffering from MFPP.

The effect of nomophobic behaviors among nurses on their clinical decision-making perceptions.

AIM: This study aimed to explore the impact of nomophobic behaviors among hospital nurses on their clinical decision-making perceptions. This understanding can offer insights to enhance the work environment, improve the clinical decision-making ability of nurses and guide medical institutions in the management of related equipment and policy development. BACKGROUND: The term "nomophobia" refers to the anxiety and fear individuals experience when they cannot use their smartphones or when smartphones are not accessible. Nursing clinical decision-making is a complex process, including a meticulous assessment of the patient's pathological condition and medical history, alongside the application of nursing knowledge and experiential learning rooted in critical thinking. The concept of clinical decision-making perceptions is defined as a deliberate cognitive understanding of one's decision-making processes, which significantly influences the clinical decision-making capabilities of healthcare professionals, thereby impacting the quality of patient care. The factors influencing these clinical decision-making perceptions have been the subject of extensive research. However, there is no Chinese research on the impact of nurses ' nomophobic behaviors on their clinical decision-making perception. DESIGN: A cross-sectional descriptive survey using online-based delivery modes was used. METHODS: A descriptive cross-sectional survey design was employed. Using convenience sampling, we surveyed the nurses from a tertiary hospital in Nanjing in May 2023. Data were gathered using a sociodemographic data form, the Nomophobia Questionnaire and the Clinical Decision-Making in Nursing Scale. Techniques including the independent sample t-test, one-way ANOVA, Pearson correlation analysis and linear regression analysis were employed to probe the degree of nomophobia and its effects on their perception of clinical decision-making. Out of 284 questionnaires gathered, 272 were deemed valid, resulting in a 95.8% effective response rate. RESULTS: The data revealed that participants exhibited a medium level of nomophobia (54.01 ± 24.09) and clinical decision-making perceptions (144.94 ± 20.08). A robust negative correlation was discerned between nomophobia and clinical decision-making perceptions (r: -0.365, P<0.001). This study highlighted that as the degree of nomophobia intensified, nurses' clinical decision-making perceptions decreased with the increase in nomophobia. CONCLUSION: Nomophobic behaviors can hamper nurses' perception of clinical decision-making, potentially leading to inaccuracies or errors. Nurses must use mobile phones judiciously, practice self-regulation and mitigate the disruptive effects of nomophobia on their decision-making. In addition, medical institutions should foster relevant education or craft policies to regularize mobile phone use, augmenting nurses' efficiency and decision-making prowess, enhancing patient care quality, diminishing medical errors and ensuring patient health and safety.

The effect of social appearance anxiety and loneliness on nomophobia levels of young adults.

BACKGROUND: Nomophobia can be defined as a disorder in which people fear being away from their smartphone. Studies on the determinants of nomophobia in young adults seem to be limited. AIM: This study aims to determine the levels of nomophobia, social appearance anxiety and loneliness in young adults and to examine the effects of social appearance anxiety and the level of social and emotional loneliness on nomophobia levels. DESIGN: This is a descriptive and correlational study. Data were collected from 687 young adults. Data were collected using the Information Form, the Nomophobia Scale, the Social Appearance Anxiety Scale, and the Social and Emotional Loneliness Scale for Adults. Descriptive and multiple linear regression statistics were used. RESULTS: The mean Nomophobia Scale score of the participants was 73.76 ± 27.46, which points to moderate nomophobia levels. The findings revealed those with a high level of social appearance anxiety have higher nomophobia levels. It was revealed that social appearance anxiety, social and emotional loneliness explain 8 % (Adjusted R2 = 0.082) of the variance in the nomophobia. CONCLUSION: A sample of 687 participants showed that young adults were relatively moderately nomophobic. In this study, social appearance anxiety, social and emotional loneliness was determined as predictor of nomophobia.

Implementation and Preliminary Outcomes of an Exposure-Based Summer Camp for Pediatric OCD and Anxiety.

Despite the high prevalence of anxiety disorders in children and adolescents and the existence of effective evidence-based treatments for them, access to psychological care remains a major public health concern. Summer camps may provide an effective treatment avenue for youth who might not otherwise have access to care. This study describes the design and implementation of Fear Facers, a semistructured, 5-day, daytime exposure-therapy-based summer camp designed for youth with a primary diagnosis of obsessive-compulsive disorder (OCD), social anxiety, separation anxiety, or a specific phobia. Preliminary data regarding feasibility and patient outcomes is also reported. Among 52 children and adolescents aged 7 to 16 who attended one of six camp sessions between 2018 and 2021, significant reductions in anxiety (d = 0.54) and OCD symptoms (d = 0.57) were observed from pre-camp to immediately post-camp. A subset of campers who were followed for an additional 3 months post-camp (n = 22) showed maintenance of treatment gains. Retention rates for the intervention were high. Our investigation provides further support for the use of a camp-based design for cognitive-behavioral approaches, and may provide a unique setting to maximize elements of inhibitory learning in exposures. We also discuss a number of elements regarding feasibility that need consideration for those hoping to develop similar interventions.

Influencing factors of kinesiophobia among stroke patients with hemiplegia: A mixed methods study.

OBJECTIVES: There is a scarcity of data regarding the effects of kinesiophobia on stroke patients with hemiplegia. Therefore, this paper aims to evaluate the level of kinesiophobia experienced by stroke patients with hemiplegia in China, examine the elements that influence it, and investigate the unique psychological experience of kinesiophobia combined with a qualitative study. METHODS: This mixed study was conducted in two steps. Four approved scales were used to evaluate a total of 163 patients: (i) Tampa Scale of Kinesiophobia, (ii) Pain Catastrophizing Scale, (iii) Self-Efficacy for Exercise Scale, and (iv) Hospital Anxiety and Depression Scale. A multivariate linear regression model was used to evaluate the predictors of kinesiophobia in stroke patients with hemiplegia. Subsequently, semi-structured interviews with 15 stroke patients with hemiplegia were conducted using an objective sampling method, and the Colaizzi 7-step analysis process was utilized to analyze the interview data. RESULTS: A total of 163 stroke patients with hemiplegia were included in this study, of them, 47.9% reported kinesiophobia. Multiple linear regression revealed that the influencing factors of kinesiophobia in stroke patients with hemiplegia were a history of falls, exaggeration, helplessness, anxiety, depression, and low exercise self-efficacy (P<0.05). The qualitative research focuses on two main topics: personal adoption of negative coping styles and insufficient external support. CONCLUSION: Our study showed that the kinesiophobia in stroke patients with hemiplegia was high, with several factors influencing their kinesiophobia. Some of these factors are modifiable and should be considered when formulating kinesiophobia intervention strategies for stroke patients with hemiplegia.

[Effect of Intelligent Health Education Based on Health Belief Model on Patients With Kinesophobia After Surgical Treatment of Cervical Spondylosis]. / åŸºäºŽå¥åº·ä¿¡å¿µæ¨¡å¼çš„æ™ºèƒ½å¥åº·æ•™è‚²åœ¨é¢ˆæ¤Žç— æœ¯åŽæåŠ¨ç—‡æ‚£è€ ä¸­çš„æ•ˆæžœç ”ç©¶.

Objective: To explore the application effect of intelligent health education based on the health belief model on patients with postoperative kinesophobia after surgical treatment of cervical spondylosis. Methods: A prospective cohort study was conducted with patients who underwent anterior cervical discectomy, decompression, and fusion surgery with a single central nerve and spine center, and who had postoperative kinesophobia, ie, fear of movement. The patients made voluntary decisions concerning whether they would receive the intervention of intelligent health education. The patients were divided into a control group and an intelligent education group and the intervention started on the second day after the surgery. The intelligent education group received intelligent education starting from the second day after surgery through a WeChat widget that used the health belief model as the theoretical framework. The intelligent health education program was designed according to the concept of patient problems, needs, guidance, practice, and feedbacks. It incorporated four modules, including knowledge, intelligent exercise, overcoming obstacles, and sharing and interaction. It had such functions as reminders, fun exercise, shadowing exercise, monitoring, and documentation. Health education for the control group also started on the second day after surgery and was conducted by a method of brochures of pictures and text and WeChat group reminder messages. The participants were surveyed before discharge and 3 months after their surgery. The primary outcome measure compared between the two groups was the degree of kinesophobia. Secondary outcome measures included differences in adherence to functional exercise (Functional Exercise Adherence Scale), pain level (Visual Analogue Scale score), degree of cervical functional impairment (Cervical Disability Index), and quality of life (primarily assessed by the Quality of Life Short Form 12 [SF-12] scale for psychological and physiological health scores). Results: A total of 112 patients were enrolled and 108 patients completed follow-up. Eventually, there were 53 cases in the intelligent education group and 55 cases in the control group. None of the patients experienced any sports-related injuries. There was no statistically significant difference in the primary and secondary outcome measures between the two groups at the time of discharge. At the 3-month follow-up after the surgery, the level of kinesophobia in the intelligent education group (25.72±3.90) was lower than that in the control group (29.67±6.16), and the difference between the two groups was statistically significant (P<0.05). In the intelligent education group, the degree of pain (expressed in the median [25th percentile, 75th percentile]) was lower than that of the control group (0 [0, 0] vs. 1 [1, 2], P<0.05), the functional exercise adherence was better than that of the control group (63.87±7.26 vs. 57.73±8.07, P<0.05), the psychological health was better than that of the control group (40.78±3.98 vs. 47.78±1.84, P<0.05), and the physical health was better than that of the control group (43.16±4.41 vs. 46.30±3.80, P<0.05), with all the differences being statistically significant. There was no statistically significant difference in the degree of cervical functional impairment between the two groups (1 [1, 2] vs. 3 [2, 7], P>0.05). Conclusion: Intelligent health education based on the health belief model can help reduce the degree of kinesophobia in patients with postoperative kinesophobia after surgical treatment of cervical spondylosis and improve patient prognosis.

Chain-mediating effects of kinesiophobia and self-efficacy on pain catastrophizing and physical activity in haemophilia patients.

BACKGROUND: There is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear. AIM: The study's aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH. METHODS: This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale. RESULTS: The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively. CONCLUSION: The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.

Exploring COVID-19 Phobia among International Chinese College Students in South Korea Before Ending COVID-19 Restrictions.

BACKGROUND: College students, considered to be the driving force of society, are highly vulnerable to COVID-19. At a time when facing a new pandemic wave in 2022, China's policy was in contrast with that of Korea. We investigated the phobia levels of international Chinese college students studying in Korea. OBJECTIVE: This study aimed to investigate the relationship between the frequency of use and trust of information sources, and COVID-19 phobia (C19P) among Chinese college students studying in Korea before ending related restrictions. METHODS: This study employed a cross-sectional design, conducting an online survey among Chinese college students studying in Korea from April 8-15, 2022 (before Korea ended the limitations due to COVID-19). Data about 319 respondents were analyzed, including socio-demographics, information variables, knowledge, attitudes, practices (KAP), and C19P. Hierarchical regression analysis with different models was used to examine the relationship between information trust, KAP, and C19P. RESULTS: Results showed that students performed well in knowledge and preventive practices, had diverse sources of getting information related to COVID-19, and highly depended on the internet and news. Students who perceived a higher severity of infection showed higher levels of COVID-19 phobia. The tendency to wear masks with family/friends, avoid crowded places, and not agree with Korean government mitigation policies reported higher levels of COVID-19 phobia. CONCLUSIONS: More authority and proactive communication strategies, such as consultations or education programs, are needed for international students to alleviate their phobias and psychological stress.

Temporal dynamics of costly avoidance in naturalistic fears: Evidence for sequential-sampling of fear and reward information.

Excessive avoidance is characteristic for anxiety disorders, even when approach would lead to positive outcomes. The process of how such approach-avoidance conflicts are resolved is not sufficiently understood. We examined the temporal dynamics of approach-avoidance in intense fear of spiders. Highly fearful and non-fearful participants chose repeatedly between a fixed no spider/low reward and a spider/high reward option with varying fear (probability of spider presentation) and reward information (reward magnitude). By sequentially presenting fear and reward information, we distinguished whether decisions are dynamically driven by both information (sequential-sampling) or whether the impact of fear information is inhibited (cognitive control). Mouse movements were recorded to assess temporal decision dynamics (i.e., how strongly which information impacts decision preference at which timepoint). Highly fearful participants showed stronger avoidance despite lower gains (i.e., costly avoidance). Time-continuous multiple regression of their mouse movements yielded a stronger impact of fear compared to reward information. Importantly, presenting either information first (fear or reward) enhanced its impact during the early decision process. These findings support sequential sampling of fear and reward information, but not inhibitory control. Hence, pathological avoidance may be characterized by biased evidence accumulation rather than altered cognitive control.

Prevalence and influencing factors of kinesiophobia in older patients with primary osteoporosis: A cross-sectional survey.

AIM: To explore the prevalence of kinesiophobia in older patients with primary osteoporosis and analyze its influencing factors. METHODS: A cross-sectional survey was conducted among 221 older patients with primary osteoporosis in a general hospital in Kunming, China. Data were collected through a sociodemographic-clinical questionnaire, Tampa Scale for Kinesiophobia-11 (TSK-11), Global Pain Scale (GPS), Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), and Hospital Anxiety and Depression Scale (HADS). SPSS 27.0 software was utilized for univariate and binary logistic regression analyses. RESULTS: The findings revealed that the prevalence of kinesiophobia in this study was 57.01 %. Age, history of fractures, chronic obstructive pulmonary disease (COPD), lumbar disc herniation, chronic pain, mindfulness, anxiety, and depression were identified as significant influencing factors of kinesiophobia in the binary logistic regression analyses. CONCLUSION: Healthcare professionals should be attentive to occurrence of kinesiophobia. Timely measures should be implemented to improve pain, anxiety and depression, and employ mindfulness interventions to mitigate kinesiophobia.

Trypophobia, skin disease, and the visual discomfort of natural textures.

In the last decade, the behavioral sciences have described the phenomenon of trypophobia, which is the discomfort felt by some individuals when viewing images containing clusters of bumps or holes. One evolutionary hypothesis for this phenomenon is that this visual discomfort represents an adaptation which helps organisms avoid skin disease and/or ectoparasites. Even though trypophobic imagery and disease imagery are both examples of visual textures, to date there has been no comparison of the visual discomfort elicited by these two specific kinds of textures within the larger context of the visual comfort elicited by natural texture imagery more generally. In the present study, we administered the Trypophobia Questionnaire (TQ) and recorded the visual comfort ratings elicited by a large set of standard natural texture images, including several trypophobic and skin disease images. In two independent samples, we found that while all observers find skin diseases uncomfortable to view, only those scoring high on the TQ rated trypophobic imagery equally uncomfortable. Comparable effects were observed using both standard ANOVA procedures as well as linear mixed effects modeling. Comparing the ratings of both high-TQ and low-TQ participants to the standard textures, we find remarkably consistent rank-order preferences, with the most unpleasant textures (as rated by both groups) exhibiting qualitative similarities to trypophobic imagery. However, we also find that low-level image statistics which have been previously shown to affect visual comfort are poor predictors of the visual comfort elicited by natural textures, including trypophobic and disease imagery. Our results suggest that a full understanding of the visual comfort elicited by natural textures, including those arising from skin disease, will ultimately depend upon a better understanding of cortical areas specialized for the perception of surface and material properties, and how these visual regions interact with emotional brain areas to evoke appropriate behavioral responses, like disgust.

Nomophobia and Alcohol, Tobacco, and Cannabis Consumption in Adolescents in Galicia.

This study aimed at exploring the association of nomophobia with alcohol, tobacco, and/or cannabis consumption among high school students. We carried out a cross-sectional study among high school and vocational training students in Galicia, Northwest Spain (N = 3,100). Collected data included nomophobia, sociodemographic variables, and alcohol, tobacco, and cannabis consumption. Nomophobia was measured using the validated Nomophobia Questionnaire. Adjusted odds ratios (ORs) and their 95 percent confidence intervals (CIs) were estimated using generalized linear mixed models. More than a quarter of the adolescents (27.7 percent) had nomophobia. We found an association between nomophobia and a high level of tobacco smoking in the last month in boys (OR = 2.16; 95 percent CI: 1.55-3.03). Nomophobia was also associated with higher odds of binge drinking in both genders (girls: OR = 1.86; 95 percent CI: 1.61-3.52; boys: OR = 2.29; 95 percent CI: 1.68-3.13) and with cannabis consumption in boys (OR = 1.74; 95 percent CI: 1.07-2.81). Our findings highlight the importance of a comprehensive investigation of the factors underlying alcohol, tobacco, and cannabis consumption in the adolescent population.

Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study.

BACKGROUND: Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. METHODS: Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. RESULTS: Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups CONCLUSIONS: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.